Realizing Transformational Change Through Quality Improvement in Public Health

Riley, William J.; Parsons, Helen; Duffy, Grace L.; Moran, John W.; Henry, Brenda Liz

doi:10.1097/phh.0b013e3181c2c7e0

Cited by 40 publications

(28 citation statements)

References 8 publications

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“…data were identified by the local DGP or ML as those that were more likely to be able to provide good quality data and that had an interest in Indigenous health, and the AHSs in many of the sites were recognised to be relatively well organised and managed; (2) because of the small number of services that provided data regularly for three or more cycles, it was not possible to do more detailed meaningful analysis of change between cycles; and (3) the difficulty in some locations of identifying key informants in health services and support organisations who had knowledge and experience of the operation of EHRs over the time frame of the project. This study limitation is inherent in the study finding regarding limited staff capability in the effective use of EHRs, which is consistent with other research that identifies staff skills and confidence as being an important limitation on effective use of EHRs (Majeed et al 2008;Kelly et al 2009;Riley et al 2010;Black et al 2011;Coiera 2013).…”

Section: Discussionsupporting

confidence: 51%

Consistency of denominator data in electronic health records in Australian primary healthcare services: enhancing data quality

Bailie

Chakraborty

et al. 2015

Aust. J. Prim. Health

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Abstract. The quality of data derived from primary healthcare electronic systems has been subjected to little critical systematic analysis, especially in relation to the purported benefits and substantial investment in electronic information systems in primary care. Many indicators of quality of care are based on numbers of certain types of patients as denominators. Consistency of denominator data is vital for comparison of indicators over time and between services. This paper examines the consistency of denominator data extracted from electronic health records (EHRs) for monitoring of access and quality of primary health care. Data collection and analysis were conducted as part of a prospective mixed-methods formative evaluation of the Commonwealth Government's Indigenous Chronic Disease Package. Twenty-six general practices and 14 Aboriginal Health Services (AHSs) located in all Australian States and Territories and in urban, regional and remote locations were purposively selected within geographically defined locations. Percentage change in reported number of regular patients in general practices ranged between -50% and 453% (average 37%). The corresponding figure for AHSs was 1% to 217% (average 31%). In approximately half of general practices and AHSs, the change was 20%. There were similarly large changes in reported numbers of patients with a diagnosis of diabetes or coronary heart disease (CHD), and Indigenous patients. Inconsistencies in reported numbers were due primarily to limited capability of staff in many general practices and AHSs to accurately enter, manage, and extract data from EHRs. The inconsistencies in data required for the calculation of many key indicators of access and quality of care places serious constraints on the meaningful use of data extracted from EHRs. There is a need for greater attention to quality of denominator data in order to realise the potential benefits of EHRs for patient care, service planning, improvement, and policy. We propose a quality improvement approach for enhancing data quality.Additional keywords: clinical information systems, electronic data extraction, primary health care, quality indicators, quality of data.

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Section: Discussionsupporting

confidence: 51%

Consistency of denominator data in electronic health records in Australian primary healthcare services: enhancing data quality

Bailie

Chakraborty

et al. 2015

Aust. J. Prim. Health

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“…6,15 In our results, only 1 regression model included barriers to implementing QI, indicating that the barriers we studied had a limited effect on participants' abilities to implement QI projects. Other QI resources accessed was the most predominant control variable included in our regression models.…”

Section: • Discussionmentioning

confidence: 87%

“…Although training LHD employees in QI approaches and tools is critical to ensure that the agency has the capacity to conduct this work, transformational change in the LHD culture to implement QI is required to assure the necessary foundation for QI implementation and success. 6 Workforce development training has been characterized by levels of cognitive learning whereby participant knowledge, skill, and ability to perform specific tasks increase as the level of instruction and opportunities to practice skills increase. 7,8 Basic learning approaches are designed to increase content knowledge, awareness, and understanding.…”

mentioning

confidence: 99%

Effectiveness of Public Health Quality Improvement Training Approaches

Davis

Vincus

Eggers

et al. 2012

Journal of Public Health Management and Practice

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“…[6][7][8][9] The following factors contributed to successes in integrating QI at OCHD: r A top-down approach with strong support and vision to devote resources to the QI summit. The core administrative team and the senior staff members are encouraged to promote the culture of QI in routine activities.…”

Section: • Discussionmentioning

confidence: 98%

A Local Health Department's Journey to the Summit

Morrow

Nguyen

Shultz

et al. 2012

Journal of Public Health Management and Practice

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As the interest in quality improvement (QI) efforts in public health agencies gathers momentum, organizations looking to initiate or strengthen QI processes may benefit from learning about existing programs. This article serves as a case study for other agencies to consider as they embark upon their QI journey. Specifically, this article reviews more than a decade of QI efforts in a mid-sized local health department and highlights areas of success (including an annual QI summit), barriers to implementation of QI, and areas needing improvement.

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Realizing Transformational Change Through Quality Improvement in Public Health

Cited by 40 publications

References 8 publications

Consistency of denominator data in electronic health records in Australian primary healthcare services: enhancing data quality

Consistency of denominator data in electronic health records in Australian primary healthcare services: enhancing data quality

Effectiveness of Public Health Quality Improvement Training Approaches

A Local Health Department's Journey to the Summit

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